Please Print, Fill out, and Return to:
Scarborough Downs
Attn: Victoria Frazier-Jones
P.O. Box 468
Scarborough, ME 04070
TEL: (207) 883-4331 FAX: (207) 883-2020
Email: vfrazierjones@verizon.net
NOTE: Before your check can be mailed you must have this Purse form and either a US W-9 or Canadian W-8ECI tax form completed.
Principal Owner: _______________________________________________________________ (Tax ID # must apply to the Principal Owner's name) Principal Owner's US Social Security # _________-______-________ Principal Owner's US Business Tax ID # _________-______-________ Canadian Tax ID # ______-______________ Telephone # (______) ________-________ USTA # __________________ Principal Owner's Address: ______________________________________ City ____________________________ State _________ Zip ___________ Second Owner: ____________________________________________ Third Owner: ______________________________________________ Principal Owner's Signature: ________________________________Date ______________ NEW! Email address: _____________________________________________ Horse List: 1. ___________________ 2. _________________________ 3. ________________________ 4. ___________________ 5. _________________________ 6. ________________________